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. 2023 Jan 15;152(2):195-202.
doi: 10.1002/ijc.34237. Epub 2022 Aug 24.

The burden of colon cancer attributable to modifiable factors-The Norwegian Women and Cancer Study

Marko Lukic  1 , Idlir Licaj  1 , Maarit A Laaksonen  2 , Elisabete Weiderpass  3 , Kristin B Borch  1 , Charlotta Rylander  1
Affiliations

The burden of colon cancer attributable to modifiable factors-The Norwegian Women and Cancer Study

Marko Lukic et al. Int J Cancer. .

Abstract

Colon cancer is the second most frequently diagnosed cancer in women in Norway, where incidence rates of colon cancer increased 3-fold between 1955 and 2014, for unknown reasons. We aimed to assess the burden of colon cancer attributable to modifiable risk factors in Norwegian women using the data from the Norwegian Women and Cancer (NOWAC) study. Self-reported information from 35 525 women from the NOWAC study were available. These included the following exposures: smoking status, alcohol consumption, body mass index, physical activity, intake of calcium, fibers, and red and processed meat. Colon cancer cases were identified from the Cancer Registry of Norway. A parametric piecewise constant hazards model was used to estimate the strength of exposure-cancer associations. Population attributable fractions with 95% confidence intervals (CIs) were calculated considering competing risk of death. The fraction of incident colon cancer attributable to ever smoking was 18.7% (95% CI 4.7%-30.6%), low physical activity 10.8% (95% CI -0.7% to 21.0%), alcohol consumption 14.5% (95% CI -2.8% to 28.9%), and low intake of calcium 10.0% (95% CI -7.8% to 24.8%). A small proportion of colon cancer cases was attributable to combined intake of red and processed meat over 500 g/week, overweight/obesity, and low intake of fibers. Jointly, these seven risk factors could explain 46.0% (95% CI 23.0%-62.4%) of the colon cancer incidence burden. Between 23% and 62% of the colon cancer burden among women in Norway was attributable to modifiable risk factors, indicating an important preventive potential of a healthy lifestyle.

Keywords: colon cancer; competing risks; modifiable risk factors; population attributable fraction; prospective cohort study.

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Conflict of interest statement

The authors declare that they have no competing interests to declare that are relevant to the content of this article.

References

    1. Cancer Registry of Norway . Cancer in Norway—Cancer Incidence, Mortality, Survival and Prevalence in Norway. Oslo, Norway: Cancer Registry of Norway; 2020.
    1. The World Cancer Research Fund/American Institute for Cancer Research . Diet, Nutrition, Physical Activity and Cancer: A Global Perpective ; 2018.
    1. International Agency for Research on Cancer . IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 100E. A Review of Human Carcinogens: Personal Habits and Indoor Combustions . Lyon, France; 2012. - PMC - PubMed
    1. Han MA, Zeraatkar D, Guyatt GH, et al. Reduction of red and processed meat intake and cancer mortality and incidence: a systematic review and meta‐analysis of cohort studies. Ann Intern Med. 2019;171:711‐720. - PubMed
    1. Zeraatkar D, Han MA, Guyatt GH, et al. Red and processed meat consumption and risk for all‐cause mortality and cardiometabolic outcomes: a systematic review and meta‐analysis of cohort studies. Ann Intern Med. 2019;171:703‐710. - PubMed

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